NAP4

Second generation SADs come highly recommended

Second generation devices, such as LMA Supreme™, come highly recommended in the recently published NAP4 audit conducted by the Royal College of Anaesthetists and the Difficult Airway Society, UK.

Recommendation:

If tracheal intubation is not considered to be indicated but there is some (small) increased concern about regurgitation risk, a second generation supraglottic airway is a more logical choice than a first generation one.

Recommendation:

In patients considered to be at low-risk of aspiration who have other factors that mean that use of a SAD is at the limits of normality (e.g. patient position, access to the airway, patient size) consideration should be given to use of a second generation SAD.

Recommendation:

In view of the above recommendations, and the frequency of these circumstances, it is recommended that all hospitals have second generation SADs available for both routine use and rescue airway management.

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